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'Dec 02 2014 5: 19PM Basics Environmental , Inc 5108349098 P. 1 <br /> ❑ <br /> j13 6TE RjjCXNEp., EHD LOG NUMBER <br /> ❑ , ' "Y !I ; ' ;l ' il�M'JOAQUIN COUNTY <br /> ❑ ENVIRONMENTAL HEALTm DEPARTMENT <br /> DEC 02, 201,' 600 East Main St. Stockton, CA 96202-3029 ' .1 <br /> Telephone: (209) 486-3420 Fax: (209) 464-0138 Wob: www,sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:--VbN kVh2 .1 BUSINESS/AGENCY, '9,�67 GS <br /> ADDRESS: CITYISTATE/ZIP, 0 A W-A—N-►..n <br /> PHONE (1): PHONE (2): FACSIMILE- T., 8 3 4 1)b 1 J3 <br /> TENTATIVE"APPOINTMENT DATE: Time: rC� Esc <br /> (Plcoco cllow 10 buolneco d.olfo from dato of opplleation oubmtttal•-Tclrtattvo only •muot be cordirmcd) <br /> ❑ CHECK BOX TO EXPEDITE RE E FEE(CASH OR CHECK ONLY)-RSOUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE-12--) ^) <br /> Eloctronic Informatlon: ❑ Llot❑ MV—Description: <br /> FILE ADDRESS EH �_OXLYf <br /> Street# Stree2 Nemo Ctitl/ Unit 1 <br /> 2. = IQ unit 2 <br /> Unit 3 <br /> G. . / Unit 4 <br /> 7. <br /> S• 0 Unit S <br /> 9. <br /> .10. l Unit 0 <br /> Specific Dere Rango of information Roquooted: From to <br /> ENVIRONMENTAL HEALTH 02PARTMLFILE$ <br /> 1N RGROUNDTAIIK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATET"'tJs TP[SEASTE <br /> 10 WASTE FACILITYNEHFCLE <br /> ERCLFANUP SITE(PION-LOP) FOOD FACILITY TIRE <br /> FJ'TKQ.ERQROUND TANK(MONITORING1REL"OYAL) DOG KENNEL ❑D9tRY <br /> OUS WASTE GENERATOR CHICKEN RANCH ASTEWATER"(REATMENT PLANT <br /> EREo PERMITTED FACILITY MOTElIH07EL ❑PumPER TRUCK/YARQ/CHEMICAL TOILETS <br /> ,TATTOOIBODY PIERCING POOLISPA LAND USE APPLICATION SITES <br /> ❑11EDICAL WAGTE FACILITY of"FLA NT RECORDS DTH ER(PLEASE SPECIFY) <br /> :WELL AND SEPTIC PHRMIT RECORDS ARE AVAILABLE FOR REyIEw: MONDAY-FRIDAY 8:00 AM-S;OOPM(EX.CLUD[Ni3 HOLIDAYS) <br /> t up tarn ndd=nnn In the opnoo above. Selocttho typo(o) of Illoo from the flat above by ohocking the appropriat© <br /> bon(ec). At loa$t one file typo MUST bo aoiected. Fnx to infl)46"135 or mail the nddroon indicated nbovo. Addroao <br /> rnngoa will not be accoptod -for additional cioulQtanco with filo oddroc000, contact the EHD. ApplIcationo rocolvod after <br /> 3:00 pm will be proceccod the next buolneoa day. <br /> 2r. Tho EHD will notify/the applicant If any EHD filen axiat An appointment for raviaw will be confirmed approxlmat©ly ton(10) <br /> days after rccoipt of applicntion. The Oleo will be held for a maximum of flvo bualness days for revlow. Appointmonto <br /> ehould bo ocheduled occordingly. <br /> 9.:.A fllo that is actively being worked on by EHD otaH may not be immodintoly evollablo for review. A now applicotlon may be <br /> cubmittod when the fl Io to avallablo. <br /> d" Any filo not ratumod In tho oAmo condition at) released will be roorgonizod by CHID otaR et the exponao of tho applicant. <br /> Futuro 1JIG rovi:wa by the oerne appllcant may roqulre a$129 deposit prior to roviow. <br /> RW)USE ONLY <br /> —Received TimeDec. 2, -2014— 4: 16PM-No. 7644 �,,,, <br />